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AT least 157 people were killed and dozens injured after a magnitude 6.4 earthquake struck western Nepal.
Buildings as far away as New Delhi, India, shook in what's been the country's worst earthquake in eight years.
Rescue workers in Nepal began digging through the rubble of collapsed houses with their bare hands on Saturday, searching for survivors.
Operations are expected to be slow, authorities said, as emergency teams must first clear roads blocked by landslides in many places.
Helicopters and small planes have also been asked to be ready to join the efforts.
The quake killed at least 36 people in Rukum district, where numerous houses collapsed, police official Narvaraj Bhattarai said.
A further 85 injured people were taken to the local hospital.
In the neighbouring Jajarkot district, 92 people were confirmed dead and 55 others injured, Nepal police spokesperson Kuber Kadayat said.
Government administration official Harish Chandra Sharma added: "We have not been able to establish any contact at the epicentre in Jajarkot."
He said security officials were working with villagers in the darkness to pull the dead and injured from fallen houses.
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But he added that reaching some spots was difficult because some of the trails were blocked by landslides triggered by the tremor and its aftershocks.
As day broke Saturday, rescue helicopters flew into the region to help out and security forces on the ground were digging out the injured and dead from the rubble, Kadayat said.
Troops were clearing roads and mountain trails that were blocked by landslides triggered by the earthquake.
Helicopters flew in medical workers and medicines to the hospitals there.
Prime Minister Pushpa Kamal Dahal also flew in on a helicopter with a team of doctors.
At least 20 people were rushed to hospital with injuries, Jajarkot district official Suresh Sunar said.
He said: "I am out in the open myself. We are collecting details but due to cold and night it is difficult to get information from remote areas."
At the regional hospital in the city of Nepalgunj, more than 100 beds were made available and teams of doctors stood by to help the injured.
"I was fast asleep when all of a sudden it started shaking violently. I tried to run but the whole house collapsed," said Bimal Kumar Karki, one of the first two people to be brought to the regional hospital.
"I tried escaping but half my body got buried in the debris,
"I screamed, but every one of my neighbours were in the same situation and screaming for help.
"It took nearly a half-hour to an hour before rescuers found me," he said.
Officials said that the death toll was expected to rise, noting that communications were cut off with many places.
"The number of injured could be in the hundreds and the deaths could go up as well," Jajarkot district official Harish Chandra Sharma told Reuters.
Nepal's National Seismological Centre said the quake occurred at 11.47pm (6.02pm GMT) in Jajarkot district of Karnali province.
Jajarkot is about 310 miles west of the capital Kathmandu.
"We have confirmed reports that five people of a family have died in Aathbiskot village. There are reports of more deaths. We cannot confirm that," Namaraj Bhattarai, a police official in neighbouring Rukum West district said, adding that the police was on the way to the site.
Local media footage showed crumbled facades of multi-storied brick houses.
Tremors were felt in neighbouring districts and as far away as Kathmandu, residents said.
"Houses have collapsed. People rushed out of their homes. I am out in the crowd of terrified residents. We are trying to find details of damages," police official Santosh Rokka said.
The earthquake shook buildings as far as New Delhi, about 375 miles away, according to witnesses.
Videos on social media platform X, formerly known as Twitter, showed people running into the street as some buildings were evacuated.
The German Research Centre for Geosciences (GFZ) pegged the earthquake at a magnitude of 6.2 and depth of 6.2 miles.
A 7.8-magnitude quake struck Nepal in 2015 killed about 9,000 people and damaged around a million structures.
Neighboring India offered to help in the rescue efforts.
Indian Prime Minister Narendra Modi shared on social media that he was deeply saddened by the loss of lives and damage due to the earthquake in Nepal.
"India stands in solidarity with the people of Nepal and is ready to extend all possible assistance," he said.
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The quake is the deadliest since 2015 when about 9,000 people were killed in two earthquakes.
Whole towns, centuries-old temples and other historic sites were reduced to rubble then, with more than a million houses destroyed, at a cost to the economy of $6 billion.